190632 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 00353173 Page 1 of 1
ONE CIVIC SQUARE A F C INTERNATIONAL INC CHECK AMOUNT: $773.72
CARMEL, INDIANA 46032 PO Box 894
715C SW ALMOND ST CHECK NUMBER: 190632
DEMOTTE IN 46310
CHECK DATE: 10/1312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4467004 31290 773.72 HAZARDOUS MATERIALS
AFC International Inc Invoice
PO Box 894
715C SW Almond St
DeMotte, IN 46310 Date Invoice
9/24/2010 31290
Bill To Ship To
Carmel Fire Department Carmel Fire Department
Gary Brandt Attn Gary Brandt
2 Civic Square 2 Civic Square
Carmel IN 46032 Carmel IN 46032
P.O. No. Terms Due Date Rep Ship Via
Verbal /Gary Net 30 10/24/2010 9/24/2010 UPS
Qty Shipped B/O Cat. No. Description Price Amount
1 1 0 907 00000 -04 Sensit HXG -3, includes hard 730.40 730.40
carrying case, 1 st set of
batteries, wrist strap, and
instructions, 1 cylinder 2.5%
methane /Air, regulator (old
part number S0158 -CAL)
1 1 0 Hazardous Hazardous fee 28.00 28.00
1 1 0 Shipping Shipping Insurance 15.32 15.32
Charges
Tracking No
Subtotal $773.72
Thank you for your order. We appreciate your business. If you have any
questions, please contact us at 1 -800 -952 -3293 or fax 219- 987 -6826. Sales Tax (0.0 $0.00
Returns subject to restocking charge. No returns will be accepted without
authorization number. Total
$773.72
VOUCHER NO. WARRANT NO.
`AFC International ALLOWED 20
IN SUM OF
P.O. Box 894
DeMotte, IN 46130
$773.72
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# 1 Dept. INVOICE N0. ACCT /TITLE AMOUNT Board Members
1120 31290 102- 670.04 $773.72 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
OCT 1 1 20 1 0
d
Jj
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by Stale Board of Accounts City Form No. 201 (Rev 19J5)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
31290 $773.72
I hereby certify that the attached invoice(s), or bill (s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer